NPIMap

Organization Active NPI

Holmes Regional Medical Center, Inc

Doing business as Palm Bay Hospital

  • General Acute Care Hospital
  • Palm Bay, FL
National Provider Identifier
1386940823
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
100316 Issued in FL
Legal business name
HOLMES REGIONAL MEDICAL CENTER, INC
Doing business as
Palm Bay Hospital
Practice address
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone
(321) 434-8000
NPI assigned
Feb 1, 2011
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HOLMES REGIONAL MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristen Pulio
Title
Evp Cfo
Phone
(301) 315-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 100316 FL Primary

Addresses

Primary practice location

1425 Malabar Rd NE
Palm Bay, FL 32907-2506

Mailing address

PO Box 749204
Atlanta, GA 30374-9204
Phone (321) 434-5055

Other identifiers 1

IdentifierTypeStateIssuer
003297500MedicaidFL

Other names 1

  • Palm Bay Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210000869 FL Part A Provider - Hospital 7214908771 Practice locations: Melbourne, FL; Palm Bay, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386940823. Details of each certification follow.

Hospital certification: CCN 100316

Legal name
HOLMES REGIONAL MEDICAL CENTER, INC.
Doing business as
PALM BAY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
May 6, 2011
Last certification
Jan 3, 2012
Beds
152
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 13, 1969 in FL
Enrollment address
1425 Malabar Road
Palm Bay, FL 32907-2506
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Palm Bay HospitalCCN 100316 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Holmes Regional Medical11 organizations share this tax ID, including this one
Part of
Holmes Regional Medical

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kristen Pulio Individual Corporate OfficerEvp/Cfo Sep 23, 2024
Robert Henry Individual Corporate DirectorBoard Member May 1, 2017
Health First Shared Services, Inc Organization, Rockledge, FL Corporation Operational/Managerial Control Sep 30, 2020
Terry Lee Forde Individual Corporate OfficerCeo Aug 5, 2024
James C Shaw Individual Corporate Director Nov 2, 2010
Anthony H Tran Individual Corporate DirectorBoard Member/Ex Officio Jan 1, 2018
Kim K Patrick Individual Corporate DirectorBoard Member Sep 30, 2022
Larry S Bishop Individual Corporate DirectorBoard Member Oct 1, 2023
Nicholas W Romanello Individual Corporate OfficerAsst Secretary Jun 1, 2017
W-2 Managing EmployeeSr VP Counsel & Chief Risk Offic Jun 1, 2017
Scott T Mikuen Individual Corporate DirectorBoard Member Oct 1, 2019
Dana Kiborne Individual Corporate DirectorBoard Member Jan 1, 2018
Joseph a Gurri Individual Corporate DirectorBoard Member May 1, 2017
T. Kent Smith Individual Corporate OfficerInterim Ceo Feb 14, 2023
Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sea Pines Rehabilitation Hospital, an Affiliate of Encompass HealthMelbourne, FL, CCN 103034 Hospital 5% Or Greater Direct Ownership Interest (25%)
Limited Partnership Interest (25%)		 Dec 29, 1994
Dec 29, 1994

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 597

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 597

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1386940823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749204",
            "telephone_number": "321-434-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MALABAR RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072506",
            "telephone_number": "321-434-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMES REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLMES REGIONAL MEDICAL CENTER, INC.",
        "enumeration_date": "2011-02-01",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "PULIO",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "EVP CFO",
        "authorized_official_telephone_number": "301-315-3569"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "100316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003297500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Bay Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palm Bay Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.